METHODS: Patients who had fistulas created at three centers from January 2018 to December 2020 were included in this retrospective study. In total, 112 patients underwent endoAVF creation [40 females, 72 males; mean age 60 years (range 18-88)]. Data collected included patient demographics, location of fistula creation, interventions performed, and brachial artery flows pre- and post-creation. Two-year cumulative patency, functional patency, and primary patency were assessed with Kaplan-Meier methodology. Factors affecting patency and maturation were examined using the Cox proportional hazards model.
RESULTS: Technical success defined as angiographically successful endoAVF creation was 97.3% (109/112). In 11 patients the fistula did not mature for dialysis use. For 98 patients (87%) with endoAVF maturation, 12- and 24-month cumulative patency was 94.3% and 91.7%. Functional patency (two-needle cannulation) at 12 and 24 months was 95.7% and 92.7%, respectively. Median maturation time is 95 days (IQR 51-231 days). Male gender and brachial vein coiling at the time of endoAVF creation were predictive of maturation. There were 34 censored events (four patients undergoing renal transplantation; 30 patients deceased). Number of reinterventions per patient year was 0.73 where 43 were maturation procedures and 101 were maintenance procedures. One Grade 3 complication occurred of arterial access puncture site pseudoaneurysm.
CONCLUSIONS: A high two-year functional and cumulative patency following endoAVF creation with the WavelinQ device was observed in this multicenter real-world experience Level of Evidence: 3 Level of Evidence III.
方法:这项回顾性研究包括2018年1月至2020年12月在三个中心创建的瘘管患者。总的来说,112名患者接受了endoAVF创建[40名女性,72名男性;平均年龄60岁(范围18-88)]。收集的数据包括患者人口统计学,瘘管创建的位置,进行的干预,肱动脉血流产生前后。两年累计通畅,功能通畅,和原发性通畅性采用Kaplan-Meier方法进行评估。使用Cox比例风险模型检查了影响通畅和成熟的因素。
结果:定义为血管造影术成功的内AVF创建的技术成功率为97.3%(109/112)。在11例患者中,瘘管未成熟用于透析。对于98例患者(87%)的内AVF成熟,12个月和24个月累积通畅率分别为94.3%和91.7%。12个月和24个月时的功能通畅性(两针插管)分别为95.7%和92.7%,分别。中值成熟时间为95天(IQR51-231天)。在内AVF产生时,男性性别和肱静脉盘绕是成熟的预测因素。共有34例截尾事件(4例接受肾移植;30例死亡)。每个患者年的再干预次数为0.73,其中43是成熟程序,101是维持程序。1例3级并发症发生于动脉通路穿刺部位假性动脉瘤。
结论:在这种多中心真实世界经验中观察到使用WavelinQ设备进行内AVF创建后的两年功能和累积通畅性高证据水平:3证据水平III。